2003, 10-15 Permit App: BLD-03-02780 Furnace, Piping.,,.#Valley
Mechanical Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley;'WA 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
PROJECT
ADDRESS: /00/4 r SID Yo%
DESCRIPTION OF WORK
PERMIT
USE:
/�� -
OWNER /l % 4A-44J
( t�
COST
EQUALS
PHONE (Daytime Contact):
MAILING ADDRESS:
FUEL BURNING APPLIANCE
•OR<100,000
1
X
(street)
(dty/state)
i
(ZIP)
FUEL BURNING APPLIANCE
CONTRACTOR: g eL r
X
LICENSE R:
•
MAILING ADDRESS:
UNLISTED APPLIANCE (ADDITIONAL FEE)
-OR<400,000
PHONE it:
924-7--
,3 q,
•
4
(street)
(city/state)
(ZIP)
5100
METHOD OF PA
❑ CASH ❑ C
•_. -
DATE: JO -/S - 0J EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
4 OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
•OR<100,000
1
X
515
-
1. r.,, cil
2
FUEL BURNING APPLIANCE
> 100,000
X
519
•
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
-OR<400,000
X
550
•
4
UNLISTED APPLIANCE (ADDITIONAL FEE)
>400,000
X
5100
-
5
USED APPLIANCE (WSEC min. AFUE rating)•
or < 400,000
X
550
-
6
USED APPLIANCE (WSEC mm. AFUE rating)
>400,000
X
5100
-
7
BOILER/REFRIGERATION
1 - 100M BTU
X
515
-
8
BOILER/REFRIGERATION
101. 50054 BTU
X
528
-
9
BOILER/REFRIGERATION
501- L000M BTU
X
539
-
10
BOILER/REFRIGERATION
1001- 1,750M BTU
X
557
•
11
BOILER/REFRIGERATION
+1750M BTU
X
595
-
12
GAS LOG, GAS INSERT, GAS FNEPLACE
-
X
510
-
13
RANGE
-
X
510
-
14
DRYER
-
X
510
-
15
FUEL BURNING WATER HEATER
-
X
510
-
16
MISC FUEL BURNING APPL.
-
X
510
-
17
GAS PIPING (ea. Outlet)
-
1
X
51
•
1 e 0
18
DUCT SYSTEMS
_
X
510
-
19
VENTILATING FANS
-
X
510
•
20
AIR HANDLER (DOES NOT Indude ducting)
• OR < 10,000CFM
X
512
•
21
AIR HANDLER (DOES NOT include ducting)
> 10= CFM
X
519
-
22
EVAPORATIVE COOLERS
-
X
510
•
23
TYPE I HOOD
-
X
550
•
24
TYPE II HOOD
-
X
510
25
HEATPUMP/AIR CONDITIONER
0.3 TON
X
512
-
26
AIRCONDMONER
3.15 TON
X
520
-
27
AIRCONDTIIONER
15-30 TON
X
525
-
28
AIRCONDITIONER
30-50 TON
X
535
-
29
AIR CONDITIONER
+50 TON
X
560
-
30
LPC STORAGE TANK
-
X
510
•
31
WOOD OR PELLET STOVE/INSERT
-
X
510
-
32
WOOD STOVE - FREE STANDING -
-
X
525
-
HENT
MVISA -.
SUBTOTAL:
/ 6 00
PLUS PROCESSING FEE:
$35.00
TOTAL TOTAL PERMIT FEE DUE: 3/ l2
•_. -
DATE: JO -/S - 0J EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: